Severe metformin intoxication treated with prolonged haemodialyses and plasma exchange.
BACKGROUND
Biguanides pose a significant risk of morbidity, mortality and permanent sequelae secondary to prolonged periods of hypoglycaemia.


OBJECTIVE
To investigate the treatment of massive metformin overdose associated with lactic acidosis.


METHODS
We present the case of a 30-year-old woman, who attempted to commit suicide by ingesting an 85-g massive metformin overdose associated with severe lactic acidosis, which we treated by performing prolonged haemodialysis with bicarbonate and plasma exchange.


CONCLUSIONS
For the maximum elimination of metformin, extended haemodialysis is required and the treatment of the accompanying metabolic acidosis with bicarbonate is important for the effectiveness of the treatment. Patients benefit much more from the treatment of combined haemodialysis with plasma exchange.
Turkcuer
Ibrahim
I
Department of Emergency Medicine, Pamukkale University, Denizli, Turkey.
Erdur
Bulent
B
Sari
Ismail
I
Yuksel
Aykut
A
Tura
Pinar
P
Yuksel
Sinemis
S
D000140:Acidosis, Lactic / Q000209:etiology / Q000628:therapy*; D000328:Adult; D062787:Drug Overdose / Q000628:therapy; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000506:poisoning*; D008687:Metformin / Q000506:poisoning*; D010951:Plasma Exchange; D006435:Renal Dialysis; D013406:Suicide, Attempted
D007004:Hypoglycemic Agents; D008687:Metformin